Resultados materno-perinatales de gestantes peruanas en Chile: Exploración del efecto del migrante sano

Contreras, Jovita Ortiz; Escobar, María Begoña Carroza; Quiroz-Carreño, Jael; Navarrete, Marcela; Bannout, Marcela Araya

doi:10.17843/rpmesp.2020.374.6098

Cited by 4 publications

(2 citation statements)

References 21 publications

(31 reference statements)

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“…Significant differences were observed in various demographic and health variables between immigrant and non-immigrant women. These findings are consistent with previous studies that have examined the composition of the immigrant population in Chile (11)(12)(13). A study conducted by Veliz et al supports the presence of a significant proportion of immigrants from the same countries mentioned.…”

Section: Discussionsupporting

confidence: 92%

“…One of the major challenges at this stage is the excessive obstetric interventionism and medicalization of childbirth, as a consequence, Chile has one of the highest rates of c-sections in the region, reaching 43.1% of total births in the public system in 2020 (8). Moreover, an increasing rate of obesity in women of childbearing age (9,10), delayed pregnancy, and barriers to access to healthcare for the immigrant population (11)(12)(13), are urgent priorities to be addressed.…”

Section: Introductionmentioning

confidence: 99%

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Immigration and C-sections incidence: Maternal care and perinatal outcomes in the context of the pandemic in Chile

Carroza Escobar,

Silva,

Ortíz-Contreras

et al. 2023

Front. Glob. Womens Health

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IntroductionImmigration has increased significantly in Chile. Despite that all pregnant women, regardless of nationality and immigration status, have the right to access to all healthcare services during pregnancy, childbirth, and postpartum, inequities in health care outcomes and health provision have been reported. During COVID-19 pandemic, these inequities are completely unknown.ObjectiveThe aim of this study was to compare the incidence of c-sections according to mother's migration status, as well as other maternal care and perinatal outcomes in women giving birth at San José Hospital in Santiago, Chile, during the COVID-19 pandemic.MethodsA retrospective cohort study was designed including 10,166 registered single births at the San José Hospital between March 2020 and August 2021. To compare between groups, statistical tests such as Chi-square and Fisher's exact were used. Log Binomial regression models were performed adjusted for potential confounding variables. To estimate the strength of association the relative risk was used.ResultsImmigrant mothers account for 48.1% of the registered births. Compared to non-immigrant women, immigrants exhibit a higher proportion of c-section, specifically, emergency c-section (28.64% vs. 21.10%; p-value < 0.001) but a lower proportion of and having a preterm birth (8.24% vs. 13.45%; p < 0.05), receiving personalized childbirth care (13.02% vs. 14.60%; p-value < 0.05), companion during labor and childbirth (77.1% vs. 86.95%; p-value < 0.001), And postpartum attachment to newborn (73% vs. 79.50%; p-value < 0.001). The proportion of COVID exposure was not significant between groups, not the severity also. Haitians had a highest risk of undergoing emergency c-section (aRR = 1.61) and Venezuelans had a highest risk of elective c-section (aRR = 2.18) compared to non-immigrants.ConclusionThis study reports high rates of c-sections in the entire population, but in immigrant populations it is even higher. Additionally, it found gaps in maternal care and perinatal outcomes between immigrants and non-immigrants. More studies are needed to elucidate the possible causes of these differences and establish new regulations to protect the reproductive rights of the immigrant population.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Immigration and C-sections incidence: Maternal care and perinatal outcomes in the context of the pandemic in Chile

Carroza Escobar,

Silva,

Ortíz-Contreras

et al. 2023

Front. Glob. Womens Health

Self Cite

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Pregestational obesity, maternal morbidity and risk of caesarean delivery in a country in an advanced stage of obstetric transition

Escobar

Contreras

Bertoglia

et al. 2021

Obesity Research & Clinical Practice

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A comparative analysis of health status of international migrants and local population in Chile: a population-based, cross-sectional analysis from a social determinants of health perspective

2022

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Background During recent decades intraregional migration has increased in Latin America. Chile became one of the main receiving countries and hosted diverse international migrant groups. Evidence have suggested a healthy migrant effect (HME) on health status, but it remains scarce, controversial and needs to be updated. This study performed a comprehensive analysis verifying the existence of HME and its association with social determinants of health (SDH). Methods We analyzed data from the Chilean National Socioeconomic Characterization Survey (CASEN, version 2017). Unadjusted prevalence of health status indicators such as negative self-perceived health, chronic morbidity, disability, and activity limitations were described in both international migrants and local population. Adjusted associations between these outcomes and sets of demographics, socioeconomic, access to healthcare, psychosocial and migration-related SDH were tested using multivariate logistic regression in each population. The HME for each health outcome was also tested using multivariate logistic regression and sequentially adjusting for each set of SDH (ref = Chilean). Results International migrants had lower unadjusted prevalence of all health indicators compared to Chileans. That is, unadjusted analysis revealed an apparent HME in all health outcomes. Age, unemployment, and health care system affiliation were associated with health outcomes in both populations. Psychosocial determinants were both risk and protective for the analysed health outcomes. After adjustment for each set of SDH, the immigrant health advantage was only significant for chronic morbidity. Being migrant was associated with 39% lower odds of having chronic diseases compared to locals (OR: 0.61; 95% CI: 0.44–0.84; P = 0.0003). For all other outcomes, HME disappeared after adjusting by SDH, particularly unemployment, type of health system and psychosocial factors. Conclusions Testing the HME in Chile revealed an advantage for chronic morbidities that remained significant after adjustment for SDH. This analysis shed light on health disparities between international migrants and local population in the Latin American region, with special relevance of unemployment, type of health system and psychosocial SDH. It also informed about differential exposures faced during migration process that could dissolve the HME over time. Evidence from this analytical approach is useful for informing health planning and intersectoral solutions from a SDH perspective.

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Resultados materno-perinatales de gestantes peruanas en Chile: Exploración del efecto del migrante sano

Cited by 4 publications

References 21 publications

Immigration and C-sections incidence: Maternal care and perinatal outcomes in the context of the pandemic in Chile

Immigration and C-sections incidence: Maternal care and perinatal outcomes in the context of the pandemic in Chile

Pregestational obesity, maternal morbidity and risk of caesarean delivery in a country in an advanced stage of obstetric transition

A comparative analysis of health status of international migrants and local population in Chile: a population-based, cross-sectional analysis from a social determinants of health perspective

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